We read with great interest the article by Sitaula et al. entitled “Efficacy of Platelet-Rich Plasma Therapy in Melasma Using Microinjections and Microneedling Techniques” 1. The authors are to be commended for conducting a rigorous randomized split-face study that addresses a critical clinical question: the optimal delivery modality for platelet-rich plasma (PRP) in melasma management. Their findings, demonstrating a statistically superior efficacy of microneedling over microinjection (70.21% vs. 36.6% improvement in modified Melasma Area and Severity Index MASI score, p 75% improvement in 46.7% of the microneedling group underscores the need for long-term follow-up. Melasma is notoriously chronic and recurrent, and durability of treatment response is paramount 5. While the open-label design may introduce bias in subjective endpoints, the concordance between modified MASI scores and global assessments strengthens the findings. However, data on relapse rates and duration of response at 6–12 months post-treatment would clarify whether microneedling with PRP offers transient improvement or sustained disease modification. Such follow-up would align with emerging research on microneedling-based strategies for long-term skin remodeling and controlled drug delivery 6. In conclusion, we applaud Sitaula et al. for their valuable contribution 1. Their work definitively establishes microneedling as the superior PRP delivery method for melasma. We encourage further research to unravel the mechanistic synergy and evaluate long-term outcomes, which could pave the way for optimized combination therapies for this challenging condition. Zhicun Han conceived the idea for this correspondence and drafted the manuscript. Dandan Wang and Ying Chen wrote the manuscript together. All authors reviewed and approved the final version. The authors declare no conflicts of interest. This article is linked to Sitaula et al. papers. To view this article, visit https://doi.org/10.1111/jocd.70246. The data that support the findings of this study are available from the corresponding author upon reasonable request.
Wang et al. (Sun,) studied this question.